Hemoglobin A1c (HbA1c) is a test used to measure long-term blood sugar control. People without diabetes and people with well-controlled diabetes usually have HbA1c results that are less than 6 percent. Studies have shown that the higher the HbA1c, the greater the chance for developing long-term problems related to diabetes, such as heart, eye, nerve, and kidney problems.
In one study, people taking alogliptin with metformin for 26 weeks lowered their HbA1c by 1.2 percent to 1.6 percent, on average. As might be expected, higher doses resulted in a greater reduction in HbA1c. In comparison, people taking metformin alone lowered their HbA1c by 0.7 percent to 1.1 percent, while alogliptin alone was associated with a 0.6 percent reduction in HbA1c.
In the same study, people given metformin with alogliptin had a decrease in their fasting blood sugar by 32 mg/dL to 46 mg/dL, on average. In comparison, metformin alone lowered fasting blood glucose by 12 mg/dL to 32 mg/dL, on average, and alogliptin alone by 10 mg/dL, on average.
As mentioned already, Kazano contains two diabetes medicines: alogliptin and metformin. These two medicines work in different ways to control blood sugar.
Alogliptin belongs to a group of medicines known as dipeptidyl peptidase-4 (DPP-4) inhibitors. DPP-4 is an enzyme that breaks down certain hormones known as incretin hormones. These hormones cause insulin to be released from the pancreas (which lowers blood glucose levels) in response to meals. They also reduce the amount of glucagon released by the pancreas, which reduces glucose (sugar) production by the liver.
By blocking the DPP-4 enzyme, Kazano increases the level of incretin hormones in the blood. This causes more insulin to be made in response to meals, and reduces the amount of glucose made by the liver.
Metformin belongs to a group of medicines known as biguanides. It lowers blood sugar levels in several ways, including by:
- Decreasing the amount of glucose made by the liver
- Decreasing the amount of sugar absorbed into the body through the small intestines
- Improving insulin sensitivity, which helps increase glucose uptake and use by cells.